The Relationship between Hospital Infection Surveillance and Control Activities and Antibiotic Resistant Pathogen Rates

Objective: The purpose of the study was to examine the relationship of surveillance and control activities in Canadian hospitals with rates of nosocomial methicillin-resistant S. aureus (MRSA), C. difficile associated diarrhea (CDAD), and vancomycin-resistant Enterococcus (VRE). Methods: Surveys were sent to Infection Control programs in hospitals that participated in an earlier survey of infection control practices in Canadian acute care hospitals. Results: One hundred and twenty of 145 (82.8%) hospitals responded to the survey. The mean MRSA rate was 2.0 (SD 2.9) per 1,000 admissions, the mean CDAD rate was 3.8 (SD 4.3), and the mean VRE rate was 0.4 (SD 1.5). Multiple stepwise regression analysis found hospitals that reported infection rates by specific risk groups (r = - 0.27, p < 0.01) and that kept attendance records of infection control teaching activities (r = - 0.23, p < 0.01) were associated with lower MRSA rates. Multiple stepwise regression analysis found larger hospitals (r = 0.25, p < 0.01) and hospitals where infection control committees or staff had the direct authority to close a ward or unit to further admissions due to outbreaks (r = 0.22, p < 0.05) were associated with higher CDAD rates. Multiple logistic regression analysis found larger hospitals (OR = 1.6, CI 1.2 - 2.0, p = 0.003) and teaching hospitals (OR = 3.7, CI 1.2 - 11.8, p = 0.02) were associated with the presence of VRE. Hospitals were less likely to have VRE when infection control staff frequently contacted physicians and nurses for reports of new infections (OR = 0.5, CI 0.3 - 0.7, p = 0.02) and there were in-service programs for updating nursing and ancillary staff on current infection control practices (OR = 0.2, CI 0.1 - 0.7, p = 0.01). Conclusions: Surveillance and control activities were associated with MRSA and CDAD rates and the presence of VRE. Surveillance and control activities might be especially beneficial in large and teaching hospitals.

DESIGN OF A MINIATURIZED SOP INTEGRATED GNSS RF FRONT-END MODULE

Navigation devices used to be bulky and expensive and were not widely commercialized for personal use. Nowadays, all useful electronic devices are turning into being handheld so that they can be conveniently used anytime and anywhere. One can claim that almost any mobile phone, used today, has quite strong navigational capabilities that can efficiently work anywhere in the globe. No matter where you are, you can easily know your exact location and make your way smoothly to wherever you would like to go. This couldn’t have been made possible without the existence of efficient and small microwave circuits responsible for the transmission and reception of high quality navigation signals. This thesis is mainly concerned with the design of novel highly miniaturized and efficient filtering components working in the Global Navigational Satellite Systems (GNSS) frequency band to be integrated within an efficient Radio Frequency (RF) front-end module (FEM). A System-on-Package (SoP) integration technique is adopted for the design of all the components in this thesis. Two novel miniaturized filters are designed, where one of them is a wideband filter targeting the complete GNSS band with a fractional bandwidth of almost 50% at a center frequency of 1.385 GHz. This filter utilizes a direct inductive coupling topology to achieve the required wide band performance. It also has very good out-of-band rejection and low IL. Whereas the other dual band filter will only cover the lower and upper GNSS bands with a rejection notch in between the two bands. It has very good inter band rejection. The well-known “divide and conquer” design methodology was applied for the design of this filter to help save valuable design and optimization time. Moreover, the performance of two commercially available ultra-Low Noise Amplifiers (LNAs) is studied. The complete RF FEM showed promising preliminary performance in terms of noise figure, gain and bandwidth, where it out performed other commercial front-ends in these three aspects. All the designed circuits are fabricated and tested. The measured results are found to be in good agreements with the simulations.